Genotypic and Phenotypic Expression of Antibiotic Resistance Patterns of Uropathogenic Enterobacteriaceae

Figures & data

Table 1 Primers Used in the Multiplex PCR for Detection of Carbapenem Genes

Genes	Primer Sequence	Product Size (bp)
bla IMP	5 ˈGGAATAGAGTGGCTTAAYTCTC 3ˈ	232
	5ˈ GGTTTAAYAAAACAACCACC 3ˈ
bla VIM	5 ˈ GATGGTGTTTGGTCGCATA 3ˈ	390
	5ˈ CGAATGCGCAGCACCAG 3 ˈ
bla NDM	5ˈ CACCTCATGTTTGAATTCGCC 3ˈ	984
	5ˈ CTCTGTCACATC GAAATCGC 3ˈ
bla KPC	5 ‘CATTCAAGGGCTTTCTTGCTGC 3ˈ	538
	5ˈACGACGGCATAGTCATTTGC 3 ˈ
bla OXA- 48	5ˈGCGTGGTTAAGGATGAACAC 3’	438
	5ˈCATCAAGTTCAACCCAACCG 3’

Table 2 Antibiotic Sensitivity Pattern of Enterobacteriaceae Members Isolated from Cases of Urinary Tract Infection

Antibiotic Subclass	Antibiotic	Resistance	Intermediate	Sensitive
β lactam, β lactam - β lactamase inhibitors	Ampicillin	267(85.9)	2(0.6)	42(13.5)
	Amoxicillin - clavulanate	131(42.1)	46(14.8)	134(43.1)
	Piperacillin- tazobactam	44(14.1)	6(1.9)	261(83.9)
	Ticarcillin- clavulanate	248(79.7)	3(1.0)	60(19.3)
Cephalosporins	Ceftazidime	144(46.3)	7(2.3)	160(51.4)
	Ceftriaxone - sulbactam	44(14.1)	6(1.9)	261(83.9)
	Cefixime	195(62.7)	7(2.3)	109(35.0)
Carbapenems	Imipenem	27(8.7)	8(2.6)	276(88.7)
	Meropenem	37(11.9)	4(1.3)	270(86.8)
	Ertapenem	39(12.5)	5(1.6)	267(35.0)
Fluoroquinolones	Ciprofloxacin	203(65.3)	12(3.9)	96(30.9)
	Norfloxacin	168(54.0)	5(1.6)	138(44.4)
	Ofloxacin	172(55.3)	5(1.6)	134(43.1)
Aminoglycosides	Amikacin	36(11.6)	5(1.6)	270(86.8)
	Gentamicin	94(30.2)	3(1.0)	214(68.8)
Others	Trimethoprim-sulfamethoxazole	156(50.2)	1(0.3)	154(49.5)
	Fosfomycin	14(4.5)	4(1.3)	293(94.2)
	Nalidixic acid	236(75.9)	1(0.3)	74(23.8)
	Nitrofurantoin	85(27.3)	47(15.1)	179(57.6)

Figure 1 Comparison between antibiotic resistance pattern of E. coli and Klebsiella spp.

Figure 2 Coexisting clinical conditions in patients with UTI.

Abbreviations: DM, diabetes mellitus; HTN, hypertension; CKD, chronic kidney disease or failure; AKI, acute kidney injury or failure.

Table 3 Carbapenem Genes Detected Enterobacteriaceae Isolates from Cases of Urinary Tract Infection

Enterobacteriaceae Members	bla IMP	bla VIM	bla KPC	bla OXA −48	bla NDM
E. coli n=99	0	0	1 (1%)	3 (3%)	6(6.1%)
Klebsiella spp. n=37	0	3(8.1%)	0	5 (13.5%)	5(13.5%)
Citrobacter koseri n=3	0	0	0	0	0
Serratia fonticola n=1	0	0	0	0	0
E. cloacae n=2	0	0	0	0	0
Morganella morganii n=2	0	1 (50%)	0	0	0
Proteus mirabilis n=1	0	0	0	0	0

Figure 3 Multiplex PCR results showing the detection of carbapenemase genes (Lane 1, Lane 10 molecular ladder; Lane 2, 3, 4, 5, 6 correspond to blaIMP, blaNDM, blaKPC, bla OXA-48, bla VIM; Lane 7 negative control of amplification; Lane 8 negative sample; Lane 9 showing bla NDM and bla OXA-48).